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Personality DisordersWhat is a Personality Disorder?People with personality disorders are generally rigid, inflexible, and unable to respond to changes. There are many subsets of personality disorders and each has its own set of symptoms. Personality disorders are grouped into three clusters into which the subsets reside.
Subsets of Personality Disorders according to the DSM IV-TR
Personality Disorder CausesA clearer scientific image of the contributing factors for personality disorders has been slowly evolving over the last two decades. Personality disorders, as with other mental health disorders, seem to have genetic, environmental, and psychological components. Studies do indicate that genetics play a role in the development of these disorders. For example, a family history of schizophrenia seems to be prevalent within Cluster A personality disorders. Remember, most people have traits associated with various personality disorders. However, in a true personality disorder, these traits are profound and always present in a pathological manner. Studies have also illustrated that biological factors are at play in developing a personality disorder: certain hormones, low levels of platelet monoamine oxidase, smooth-pursuit eye movements (jumpy eyes which seem to be inherited and present in certain personality disorders), levels of neurotransmitters (such as endorphins and serotonin levels), and finally, changes in brain waves are now important considerations in understanding and treating specific personality disorders. (Synopsis of Psychiatry, tenth edition, Ch. 27, pp.791-792).
Psychosocial dynamics known as defense mechanisms help people suffering from personality disorders cope with their feelings. This is a subconscious process of working out internal conflicts. Defense mechanisms are developed in childhood and internalized. Childhood experiences and relationship to parents can then combine to become triggers for personality disorders.
The diagnosis of personality disorders is complicated when other psychiatric or substance abuse disorders are also present (or co-exist). “Substance dependent patients also display the full range of personality disorders...” Substance-related disorders, personality traits, or general medical conditions may alter personalities further confusing a clear diagnosis. General Symptoms of Personality DisordersIt is typical of individuals suffering from a personality disorder to have a unique perspective on their actions and responses to life’s events. Others not suffering from these disorders are surprised and disturbed at the emotional responses of the sufferers because personality disorder cognitive responses are considered outside the norm of society’s culture. People with personality disorders exhibit extremes in:
“Cluster A” Personality DisordersParanoid Personality Disorders (PPD) What is Paranoid Personality Disorder?People who seem extraordinarily angry, overly suspicious, who refuse to take responsibility for their emotions, and who perceive others as ready to do harm have characteristics of paranoid personality disorder. Such disorder characteristics manifest during childhood.
Symptoms of Paranoid Personality Disorders
Because people with PPD struggle with an intensely dangerous and threatening outside world, they move toward isolation -- avoiding normal social interactions and often expressing disdain for others. They “see [others] as weak, sickly, or impaired…Persons with paranoid personality disorders may appear business-like and efficient, but they often generate fear or conflict in others”. (Synopsis of Psychiatry, tenth edition, p. 794). Schizoid Personality DisordersWhat is Schizoid Personality Disorder? This disorder is part of the odd and eccentric behavior cluster. People with schizoid personality disorder exhibit an intense need to be alone. They are viewed as detached, distant or indifferent. They do not seek social interactions of any type and generally tend to work in jobs that are solitary, often working in the evenings. Symptoms of Schizoid Personality Disorders
Schizotypal Personality Disorder This disorder is not to be confused with schizophrenia because sufferers of schizotypal personality disorders do not experience hallucinations with the same frequency or type nor are they as disconnected from reality. According to government statistics, almost half of those who suffer from schizotypal personality disorders also suffer from major depressive disorders and/or a secondary personality disorder. (http://www.nlm.nih.gov/Medlineplus/article/001525.htm) People with this disorder generally have unusual beliefs that they strongly defend such as insisting on the existence of aliens and validity of witchcraft. Often people with this disorder are highly empathetic, believing that they have clairvoyant abilities. Yet, their inappropriate social responses and peculiar speech lead them to isolation. Unlike people suffering from schizoid personality disorder, people with schizotypal personality disorder are disturbed by their inability to maintain close relationships. (Synopsis of Psychiatry, tenth edition, p. 796). Symptoms of Schizotypal Personality Disorder
“Cluster B” Personality DisordersAnti-Social Personality Disorder (APD)What is Antisocial Personality Disorder? Children that express chronic patterns of behavior which violate other people’s or animal’s rights, who consistently do harm, and who are regularly involved in illegal activities display characteristics of anti-social personality disorder. These patterns of behavior, coupled with a propensity to manipulate and exploit others, continue into adulthood. There is a predisposition among males to suffer from APD (though some argue that females are under diagnosed). If there is a first-degree biological relative diagnosed with the disorder, there is a greater risk of a biological link (though some research claims otherwise). With anti-social personality disorder there also is an increased risk of substance-related disorders. Symptoms of Antisocial Personality Disorder
Borderline Personality Disorders (BPD)What is Borderline Personality Disorder? Borderline personality disorder is an emotional disorder that creates a distorted self-image. People suffering from BPD face instability in interpersonal relationships, self-image, affect, and impulsive behavior; they are always overcome with a fear of abandonment. Such individuals make “frantic efforts to avoid real or imagined abandonment.” (DSM IV-TR) These irrational responses to relationships lead to extreme, and swift mood changes, extreme anger, sudden changes in opinion and careers, panic attacks, unreasonable expectations of people’s time, and even despair. People who have BPD experience a constantly changing sense of self. They view themselves only in terms of being bad. The innocent actions of others, like being a few minutes late, becomes a statement about the BPD’s own lack of worth. This type of challenge produces extreme shifts in the perspective of others, as persons with BPD move quickly from holding someone in high esteem to suddenly devaluing that person. According to the National Institute of Mental Health, borderline personality disorder is more common than bipolar disorder or schizophrenia and affects two percent of young Americans, mostly women. “There is a high rate of self-injury without suicide intent…a significant rate of suicide attempts and completed [suicides] in severe cases. Patients [with borderline personality disorder]…account for 20 percent of psychiatric hospitalizations…” (NIMH) Symptoms of Borderline Personality Disorder
Histrionic Personality Disorder (HPD)What is Histrionic Personality Disorder? Histrionic personality disorder seems to affect more women than men. The source of the disorder remains unknown, though it has its origins in childhood. Some psychiatrists believe that it is an attention-seeking disorder, as its main symptom is excessive emotional displays. For people with HPD, there is an overwhelming need to be the center of attention, and a tendency to emphatically express their opinions without the ability to factually support their views. They are known to overreact to other people’s behaviors or comments and distort ordinary situations. Sufferers of HPD are impressionable and change their minds quickly. Symptoms of Histrionic Personality Disorder
Narcissistic Personality Disorder (NPD)What is narcissistic personality disorder? People suffering from narcissistic personality disorder believe that the world revolves around them. They believe they are the center, or should be the center, of everyone’s universe. They hold themselves in high esteem. “Latest evidence indicates that narcissists are actually secure or grandiose at both levels. [They] tend to be defensive when their self-esteem is threatened (e.g., being ridiculed); [but] narcissists can [also] be aggressive”. (Psychology Today, online, 2010, http://www.psychologytoday.com/conditions/narcissistic-personality-disorder) Mostly men suffer from narcissistic personality disorders. Scientists now believe that this disorder begins in childhood and is the result of parental neglect. Years ago it was thought to be the result of overindulgent parents who showered an unreasonable amount of praise upon the child. Instead, it is now believed that parental disdain and the unacceptability of childhood fears contributes to a child’s development of narcissistic personality disorder. People who suffer from this disorder tend to lack the ability to empathize with others. (http://www.mayoclinic.com/health/narcissistic-personality-disorder) Symptoms of Narcissistic Personality Disorder
“Cluster C” Personality DisordersAvoidant Personality Disorder (APD)What is Avoidant Personality Disorder? Avoidant personality disorder usually afflicts people who suffer from severe anxiety in social circumstances. People who suffer from APD worry about their own shortcomings and the belief that they will be rejected and criticized by others. Out of necessity, they avoid involvement with others. They choose loneliness over the fear of rejection. People with APD are not a-social, but to sustain a relationship they demand complete acceptance. People with this condition are likely to turn to substance use to negotiate their shyness and sense of isolation. Symptoms of Avoidant Personality Disorder
Avoidant personality disorder thrusts one into isolation, but it differs from the isolation of schizoid personality disorder. APD sufferers will be eager to perform in a work environment but will not seek positions of responsibility or seek job advancement. They are not demanding, irritable or unpredictable. (Synopsis of Psychiatry, tenth edition, p. 804). Dependent Personality Disorder (DPD)What is Dependent Personality Disorder? Dependent personality disorder is the most common of the personality disorders. People suffering from this disorder are unable to make any decisions about themselves whether large or small. They tend to be submissive and clinging, always seeking other’s approval for everything. They refuse to take any responsibility for their lives: what to wear, where to go to school, what type of work to do, or even who to befriend. At times, a serious medical condition can be the source of this disorder. However, it usually begins in childhood afflicting both men and women equally. Fear of abandonment from important people in life characterizes the major symptom of the person suffering from DPD. Because of the nature of this disorder, people with dependent personality disorder will submit to abuse in their primary relationships. Conceptually, sufferers of DPD cannot claim responsibility for their role in their relationship dynamics. This leaves people with DPD more susceptible to physical, psychological, and sexual abuse. Symptoms of Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder (OCPD)What is obsessive-compulsive personality disorder? First, it should be noted that OCPD is a separate and different disorder than OCD. OCPD is a global personality disorder. People suffering from OCPD experience an excessive need to be orderly, to be perfect, and to maintain mental and interpersonal control. They stubbornly insist that everything be done their way. Ironically, their perfectionism leads them to indecisiveness. “Individuals with this disorder may be miserly and stingy and maintain a standard of living far below what they can afford, believing that spending must be tightly controlled to provide for future catastrophes”. (DSM IV®, fourth edition, p. 726) The severity of perfectionism that afflicts people with OCPD stops them from completing tasks. The symptoms of this personality disorder manifest in early adulthood. Symptoms of Obsessive-Compulsive Personality Disorder
There are other personality disorders not listed or discussed above such as: depressive personality disorder, passive-aggressive personality disorder, sadistic personality disorder, and sadomasochistic personality disorder. People who suffer from personality disorders more often than not will not seek treatment on their own. Many will resort to self-medicating (substance abuse and alcoholism) to manage their feelings. Research studies over the course of two decades have repeatedly found that patients with certain types of personality disorders have an elevated risk of substance abuse and that substance abusers are likely to have at least one co-occurring personality disorder. |
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